Polysaccharides isolated from natural products, have raised an increasing interest due to their variety of beneficial health effects. Plantago spp., a valuable Chinese herbal plant, has a long history of cultivation and is widely accepted as traditional herbal medicines and functional foods in Asian counties. Polysaccharide is a very important biological active ingredient in the Plantago spp., which has a variety of biological effects, including immunomodulatory, antioxidant, antitumor, and hypoglycemic activities, among others. A large number of articles have been reported the structural identification and activity evaluation of psyllium polysaccharides. However, the structure-activity relationship of psyllium polysaccharides has not been well established. Therefore, this review focused on the extraction, purification, structural characterization, chain conformation, and biological activities of psyllium polysaccharides, which can provide useful research underpinnings and updated information for the development and application of related polysaccharides in functional foods and medicinal field.